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Jeremy Hunt has said the “door is open for constructive discussions” with junior doctors, as they begin three days of strike action in England over pay and conditions.

The walk-out started at 7am on Wednesday, after negotiations between the British Medical Association (BMA) and the Department of Health broke down earlier this month.

Reports suggested an additional pay rise of around 3% – on top of the 8.8% recommended by the independent pay review body in April – was put on the table by the government.

But the BMA said that would amount to real-term pay cuts for its members following years of below-inflation pay rises, with only a rise of 35% bringing pay back to 2008 levels.

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A final offer is not understood to have been made by Health Secretary Victoria Atkins before the BMA’s deadline, leading to the union announcing fresh strike dates.

Junior doctors, who are qualified but are undertaking further training after medical school, make up nearly half of all doctors in the English NHS system.

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Health charities and organisations issued a plea to junior doctors to call off the industrial action over fears patients could be left “stranded” in hospital over Christmas as they wait to be discharged.

The groups, including Age UK and the NHS Confederation, also said it would be “extremely difficult to ensure safe and effective care during this period for all patients that need it”.

But the BMA’s chair of council, Philip Banfield, said for patients to get the care they needed, the government had to “invest in the expertise required to deliver this”, adding: “This is the last strike action of 2023, which will have seen 28 days of action by junior doctors.

“The government is entirely capable of making the total for 2024 zero days – but it needs to make a serious and credible offer now that we can put to members.”

Heath secretary Victoria Atkins MP
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Heath secretary Victoria Atkins has been holding talks with the BMA since taking on her new role

This latest round of strikes is impacting services across the country, with Cheltenham A&E among those closing during the action.

But the NHS has said emergency and urgent care will be prioritised during the strikes, with routine care the most affected.

Speaking to reporters on Wednesday, the chancellor said the walk-outs were “incredibly disappointing”.

Mr Hunt added: “The health secretary has said her door is open for constructive discussions.

“When it comes to this government’s commitment to the NHS, we have 25,000 more doctors than we had in 2010, and we’ve increased funding by more than a third in real terms, so we have shown our commitment to the NHS.

“And more than a million NHS workers have recognised that by settling for a fair and reasonable pay deal, and I hope junior doctors to the same.”

But the BMA’s junior doctors committee said it was “extremely disappointing to be in this position”, with its co-chairs, Dr Robert Laurenson and Dr Vivek Trivedi, saying: “We had hoped that after a much-improved tone and approach from the new health secretary… we were close to a solution to this dispute.

“We have spent the last two weeks awaiting this final offer in the hope it would be the long-awaited credible offer we could put to our members. Unfortunately, we are still yet to hear it.”

They called on Ms Atkins to “show true leadership and leave behind the dogma that has been holding talks back”, adding: “She needs to be willing to talk to us regardless of whether strikes are scheduled.

“After so many missed opportunities in 2023 to settle the dispute, at a cost of £2bn to the NHS, surely now is the moment to conclude that everyone’s time would be saved by cutting out unnecessary posturing. Patients in need of care deserve nothing less.”

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NHS funding: ‘We’ve stolen from tomorrow’

Further strikes are planned for January, with junior doctors due to walk out for six consecutive days – the longest action ever taken by NHS staff.

Junior doctors in Wales are planning a 72-hour strike from 15 January, while junior doctors in Northern Ireland are being balloted for potential strike action.

Staff in Scotland have already come to an agreement with the Scottish government.

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Crypto influencer found dead in Montreal park months after abduction

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Crypto influencer found dead in Montreal park months after abduction

A 32-year-old woman has been charged with murdering Mirshahi. However, it isn’t confirmed whether the case has ties to his involvement with crypto. 

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Assisted dying opponents believe they have the momentum – as Streeting criticised for ‘overstepping the mark’

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Assisted dying opponents believe they have the momentum - as Streeting criticised for 'overstepping the mark'

Labour MPs who are opposed to legalising assisted dying believe the momentum is swinging behind their side of the campaign, Sky News has learnt.

MPs are currently weighing up whether to back a change in the law that would give terminally ill people with six months to live the choice to end their lives.

At a meeting in parliament on Wednesday, Sky News understands Labour MPs on the opposing side of the argument agreed that those who were undecided on the bill were leaning towards voting against it.

One Labour backbencher involved in the whipping operation for the no camp told Sky News: “The undecideds are breaking to us, we feel.”

The source said that many of those who were undecided were new MPs who had expressed concerns that not enough time had been given to debate the bill.

“They feel they are too new to be asked to do something as substantive as this,” they said.

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Issues that were being brought up as potential blocks to voting for the legislation include that doctors would be able to suggest assisted dying to an ill patient, they said.

The source added: “We were elected to sort the NHS out rather than assisted dying.

“And there is no going back on this – if any doubt, you should vote it out.”

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Labour MP Kim Leadbeater discusses End of Life Bill

The Terminally Ill Adults (End of Life) Bill, put forward by Labour MP Kim Leadbeater, is due to be debated on 29 November, when MPs will be given a “free vote” and allowed to vote with their conscience as opposed to along party lines.

In a recent letter to ministers, Cabinet Secretary Simon Case said the prime minister had decided to “set aside collective responsibility on the merits of this bill” and that the government would “remain neutral” on its passage and the matter of assisted dying.

There has been much debate about the bill since its details were published on Monday evening, including that the medicine that will end a patient’s life will need to be self-administered and that people must be terminally ill and expected to die within six months.

Ms Leadbeater, who has the support of former government minister Lord Falconer and ChildLine founder Dame Esther Rantzen, believes her proposed legislation is the “most robust” in the world and contains safeguards she hopes will “reassure” those who are on the fence.

They include that two independent doctors must confirm a patient is eligible for assisted dying and that a High Court judge must give their approval.

The bill will also include punishments of up to 14 years in prison for those who break the law, including coercing someone into ending their own life or pressuring them to take life-ending medicine.

She has also argued the fact terminally ill patients will have to make the choice themselves and administer the drugs themselves “creates that extra level of safeguards and protections”.

However, several cabinet ministers – including Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood, who would be responsible for the new law – have spoken out against the legislation.

Mr Streeting, who has said he intends to vote against the bill owing to concerns that people might be coerced into taking their own lives, announced a review into the potential costs of assisted dying if it is implemented.

The health secretary warned that a new assisted dying law could come at the expense of other NHS services – and that there could be “trade-offs” elsewhere.

Sky News understands Ms Leadbeater has said she is “disappointed” by Mr Streeting’s comments about the bill.

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Tory MP: ‘Impossible’ for assisted dying bill to be safe

And another Labour MP who is voting for the legislation told Sky News they believed Mr Streeting had “overstepped the mark”.

“I think it’s a bit of a false exercise,” they said.

“It’s definitely going to raise eyebrows – it’s one thing to sound the alarm but he is purposefully helping the other side.”

The MP said that while it did feel “the momentum is moving away from us, a lot of it will come down to the debate and argument in the chamber”.

“Some of the scaremongering tactics might backfire,” they added.

“It’s still all to play for but it’s undoubtedly true the other side seems to be making headway at the moment.”

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Where it’s already legal and why it’s controversial

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A source close to Mr Streeting told Sky News: “Wes has approached this issue in a genuine and considerate way, setting out his own view while respecting others’ views.”

As a private member’s bill that has been put down by a backbencher rather than a government minister, the legislation will not receive as much time for consideration as a government bill – but proponents say it can always be amended and voted down at later stages.

At Prime Minister’s Questions on Wednesday, Tory MP Sir Alec Shelbrooke questioned whether enough time had been set aside to debate the bill and urged Sir Keir Starmer to allow two days, or 16 hours, of “protected time” to “examine and debate” the legislation before the vote.

Sir Keir replied: “I do think there is sufficient time allocated to it but it is an important issue.”

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Assisted dying: Wes Streeting orders review into potential costs of changing the law

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Assisted dying: Wes Streeting orders review into potential costs of changing the law

Health Secretary Wes Streeting has ordered his department to carry out a review of the costs of potentially changing the law to legalise assisted dying.

Mr Streeting, who intends to vote against a landmark bill on the issue, has warned that a new assisted dying law could come at the expense of other NHS services if it is implemented.

It comes as MPs weigh up whether to vote for a change in the law when given the opportunity to do so later this month.

The Terminally Ill Adults (End of Life) Bill, put forward by Labour MP Kim Leadbeater, would give terminally ill people with six months to live the choice to end their lives.

There has been much debate about the bill since its details were published on Monday evening, including that the medicine that will end a patient’s life will need to be self-administered and that people must be terminally ill and expected to die within six months.

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Ms Leadbeater, who has the support of former government minister Lord Falconer and ChildLine founder Dame Esther Rantzen, believes her proposed legislation is the “most robust” in the world and contains safeguards she hopes will “reassure” those who are on the fence.

More on Assisted Dying

They include that two independent doctors must confirm a patient is eligible for assisted dying and that a High Court judge must give their approval.

The Labour MP has argued the fact terminally ill patients will have to make the choice themselves and administer the drugs themselves “creates that extra level of safeguards and protections”.

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MP discusses End of Life Bill

However, several cabinet ministers – including Mr Streeting and Justice Secretary Shabana Mahmood, who would be responsible for the new law – have spoken out against the legislation.

Announcing the review, Mr Streeting said: “Now that we’ve seen the bill published, I’ve asked my department to look at the costs that would be associated with providing a new service to enable assisted dying to go forward, because I’m very clear that regardless of my own personal position or my own vote, my department and the whole government will respect the will of parliament if people vote for assisted dying.”

Ms Leadbeater has said she is “disappointed” with Mr Streeting’s comments – telling The House magazine the health secretary’s comments “suggest he hasn’t read the bill”.

While the health secretary has warned of the potential cost downsides for the NHS, his critics have pointed out there may be potential savings to be made if patients need less care because they choose to end their own lives – something Mr Streeting branded a “chilling slippery slope argument”.

“I would hate for people to opt for assisted dying because they think they’re saving someone somewhere money – whether that’s relatives or the NHS,” he said.

“And I think that’s one of the issues that MPs are wrestling with as they decide how to cast their vote.

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‘Impossible’ for assisted bill to be safe

“But this is a free vote – the government’s position is neutral.”

Speaking to reporters after delivering a speech to the NHS Providers conference in Liverpool, Mr Streeting said there were “choices and trade-offs” and that “any new service comes at the expense of other competing pressures and priorities”.

“That doesn’t mean people should vote against it on that basis,” he said.

“People need to weigh up this choice in the way that we’re weighing up all these other choices at the moment.”

Read more:
Why is assisted dying controversial – and where is it legal?
Cancelled pay rises for managers among proposed NHS reforms

MPs will debate and vote on Ms Leadbeater’s Private Member’s Bill on 29 November, in what will be the first Commons vote on assisted dying since 2015.

The government has given MPs a “free vote” on the issue, meaning they will be able to vote according to their conscience and without the pressure to conform to party lines.

In 2015, a bill by former Labour MP Rob Marris that would have made it legal for the terminally ill to end their lives was defeated in the Commons by 330 votes to 118.

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